Abstract
BACKGROUND: Multiple sclerosis is an immune-mediated disease of the central nervous system. Progressive brain atrophy is a known marker of patient disability and cognitive impairment in MS patient, but limited information is available about the clinical and cognitive consequences in the pediatric population. CASE REPORT: We present a case of aggressive pediatric-onset MS with severe rapidly progressive brain atrophy, neurological disability, and cognitive deterioration. Serial brain MRI studies demonstrate ongoing cerebral atrophy correlating with severe deficits on serial neuropsychological testing. CONCLUSIONS: A subset of pediatric MS patient may be vulnerable to severe cognitive deterioration associated with marked brain atrophy.